Resident and Family
Councils
Office of the State Long-Term Care Ombudsman
Program Field Representative, Kathryn White
Why have a council?
Image 1: Goodwin House Alexdria Resident Council
The lives of the residents are heavily controlled by laws, rules, and
policies set by the government and nursing home. Compromises in
lifestyle become necessary due to health problems and living conditions.
These compromises and controls can make nursing home residents feel
their opinions and preferences do not matter. A council gives the
residents an active role in their life and a chance to influence decisions
that affect them.
http://www.atlantalegalaid.org/fact16.htm
What is a resident council?
Resident Council-Resident councils are organized,
self-governing, decision-making groups of long-term care
residents meeting regularly to voice their needs and
concerns and to have input into the activities, policies,
and issues affecting their lives in the facility.
http://health.mo.gov/seniors/ombudsman/pdf/HowToOrganizeAnd_DirectAnEffectiveResidentCouncil.pdf
What is a family council?
Family Council- A family council is a self-led, selfdetermining group of consumers - families and friends of
nursing home residents that:
 • Works to improve the quality of care and quality of life
of the facility’s residents.
 • Provides families with a voice in decision-making that
affects them and their loved ones.
http://health.mo.gov/seniors/ombudsman/pdf/FamilyCouncils.pdf
Education
Communication
Understand
Voice
Policy
Advocate
Surroundings
Friendship
• Providing general information about long -term
care.
• Effective way between staff and residents/
families.
• Departments as they relate to the resident’s
care and service needs.
• Present ideas, suggestions, and concerns and to
work cooperatively towards a solution.
• Learn reasons for proposed changes in policy and
procedures and promote feedback concerning
potential changes.
• Help individuals speak out about concerns and
help overcome fear of retaliation.
• Improve the atmosphere.
• Promote support.
• http://www.tjaaa.org/resident-family-councils-nursing-homes.aspx
Family council is not….
FAMILY NIGHT is a
name used in many facilities
for occasional educational
or social functions planned
and hosted by nursing
home staff for families and
friends of the home’s
residents. While these
programs may be beneficial,
they are not substitutes for
family councils.
A RESIDENT COUNCIL: Many
homes have resident councils. It
may seem at first glance that the
two groups are the same.
Combining the home’s resident and
family councils into one group may
even be considered. However, this
ignores the fact that residents and
their families have different
interests, needs and abilities.
Combined resident/family councils
are usually dominated by the
families, who are quicker and
better able, in many cases, to
express themselves. Residents and
families need their own councils
geared to their special situations
and interests.
A VOLUNTEER
GROUP OR
AUXILIARY: Occasionally,
a family council will be
started to meet a need
within the facility. Family
councils provide many
valuable services to
residents, but they must
never be replacements for
adequate staff. Also, a
council should not provide
items or services that the
home is required by law to
provide.
http://econline.net/Knowledge/Articles/familycou
ncil.html
Where to start?
Do they want a council?
Are staff and administration willing to help
the council get started?
How to introduce members to the council?
How to participate?
Image 2: avoidance300.jpg
Laws and Regulations
 Older Americans Act
 Omnibus Reconciliation Act of 1987 (OBRA
’87)
 Federal Regulations
 State Nursing Home Regulations
 Assisted Living Regulations
 Nursing Home Care Act
 Enforcement
Older Americans Act
 Every State Required to have a Long-Term Care Ombudsman Program.
 The OAA set out specific objectives for maintaining the dignity and welfare
of older individuals and created the primary vehicle for organizing,
coordinating and providing community-based services and opportunities for
older Americans and their families.
 Section. 712. STATE LONG-TERM CARE OMBUDSMAN PROGRAM.
 (H)(i) provide for training representatives of the Office;

(ii) promote the development of citizen organizations, to participate in
the program; and

(iii) provide technical support for the development of resident and
family councils to protect the well-being and rights of residents
OBRA ‘87
 1987 Congress passed the Nursing Home Reform Law as part of
the Omnibus Reconciliation Act of 1987 (OBRA 87).
 Established national standards for care and residents’ rights for
people in nursing homes.
 Each resident be provided with services sufficient to attain and
maintain his or her highest practicable physical, mental, and psychosocial well-being.
 New federal requirements were established, including: a resident
assessment process leading to development of an individualized
service plan, the right to organize and participate in family or
resident councils, the right to be free of unnecessary restraints
(physical or chemical), and specific requirements for those most
responsible for resident dignity and care.
Federal regulation 42 C.F.R. § 483.15 explains the role of the
resident and family council:
(c) Participation in resident and family groups.
(1) A resident has the right to organize and participate
in resident groups in the facility.
(2) A resident's family has the right to meet in the facility
with the families of other residents in the facility;
(3) The facility must provide a resident or family group, if one
exists, with private space;
(4) Staff or visitors may, attend meetings at the group's
invitation;
(5) The facility must provide a designated staff person
responsible for providing assistance and responding to written
requests that result from group meetings;
(6) When a resident or family group exists, the facility must
listen to the views and act upon the grievances and recommendations
of residents and operational decisions affecting resident care and life
in the facility.
State Nursing Home Regulations
OSDH 310: 675-7-7.1 Resident’s Advisory Council
Establish Council
Consist of all current NH facility residents or their
designated representative, facility coordinate and assist ,
and respond to request
No one from facility member
Private space
Minutes prepared/ maintained by staff
Communicate to administrator opinions/ concerns
Assisted Living Rules
OSDH 310:663-15-1 Residents Rights
 Observe all residents rights and responsibilities
enumerated under Title 63 O.S. Section 1-1918 (B)
http://www.ok.gov/health2/documents/LTC%20Continuum%20of%20Care%20&%20AL%20Rules.pdf




Nursing Home Care Act Title 63 O.S.
State Statue 63-1-1918 Rights and Responsibilities
2. Every resident shall have the right to have private
communication, including…..and meetings of family and
resident groups……….
3a (1) Present grievances…….
3b The family of residents shall have the right to meet in
the facility with other residents’ families.
http://www.ok.gov/health2/documents/HRDS%20675%20NHCA%201113.pdf
Enforcement F-243
This requirement does not require that residents’ organize a resident
or family group, however facilities must allow them to do so without
interference.
State Statue 483.15 © Participation in Resident and
Family Group
 -organize and participate
 -family members meet with other families
 -private space
 -staff/visitors attend by invitation
 -provide staff person
If one does not exist, determine if residents have attempted to form one but have
been unsuccessful; and if so, why.
http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf
Enforcement F-244
State Statue 483.15 © (6) When a resident or
family group exists, the facility must listen to
the views and act upon the grievances and
recommendations of the residents and family
members concerning proposed policy and
operational decisions affecting resident care
and life in the facility.
http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf
Preparation for Meeting
Leadership
Who will facilitate?
Liaison
Regular
Meeting Time
Goals/
Ground Rules
Meeting Length
Confirm Meeting
Room/
Refreshments
Minutes
By-Laws
Agenda
Topic/Guest
Speakers/
Presentation
Meeting Procedures
Image3:
clipart_people_desk_meeting_19909_1920x1200.jpg
Enthusiasm
Agenda
Sign-in
Sheet
Invite
Initial
Meeting
Next
Meeting
Handouts
Guest
Speaker
Participation and
Sharing
Leadership & Structure
Models Of Leadership
 Traditional/Town Meeting-Chair Person/ President,
Vice-Chairperson/ Vice-President, Secretary, and
Treasurer.
 Co-Leaders- Two members share responsibility.
 Leadership Committee-several family members share
responsibilities, or for first few months then have formal
election.
 Leadership committee with rotation
 Alternating Leader
 Representative-residents bedfast, serving as liaison for
other residents.
Leadership & Structure
Elections
Job Description
Training for Leaders
Term Limits
What makes a good leader?
Identify
Personal Qualities
Relate to People
Lifetime Learners
Seek Assessment
Image 3: Does it look like what makes up a good leader.
Duties of Officers
 Chairperson/ President-Presides over meeting, seeing bylaws and procedures are followed, keeping control over
meeting, maintaining impartiality, coordinates activities,
maintain communication with staff.
 Vice Chairperson/ Vice President-Fill in when chairperson is
unable to fulfill duty.
 Secretary-Taking notes at meetings, recording and
maintaining a file of the minutes, maintaining
correspondence, and having by-laws handy at meetings in
case of questions.
 Treasurer- Receiving and dispensing funds, maintaining
proper financial records, and reporting to the council on
status of treasury.
http://health.mo.gov/seniors/ombudsman/publications.php
Liaison/ Staff Assistant
A facility appointed staff advisor or liaison is required to support the council and respond
to written requests/concerns arising from the council meetings. The liaison may or may not
be invited to attend the meeting. In the beginning be clear of the role of the assistant.
http://www.tjaaa.org/resident-family-councils-nursing-homes.aspx
•
•
•
•
•
•
•
•
•
Help to tell families/ new residents
Advise council on changes in facility
Explain the facility's policies and procedures
Help council communicate its questions
Help to book guest speakers
Provide refreshments and make copies
Share information
Educate staff
Enthusiasm
No…No
Planning and running meetings
Speaking on behalf of residents
Selecting meeting times and dates, topics, activities…
Image 4: Runnells Hospital Staff
Members Honored by Resident
Council
Parliamentary Procedure
Robert’s Rules of Order
The Standard Code of Parliamentary
Procedure ( formerly the Sturgis Standard
Code of Parliamentary Procedure)
Why Do Groups Use Parliamentary Procedure?
To give everyone a chance to be heard
To allow members to participate in an orderly group
To establish and maintain order in a meeting
To prevent confusion when discussing club business
To keep things moving
Image 6: graphics-agenda-603334.jpg
 Opening Activity-Roll call/ name tags everyone becomes
acquainted
 Read Minutes from last meeting-what has happened since
 Receive Reports-discuss needs, concerns, and activities of
residents they represent
 Unfinished Business- review from previous meeting
 New Business-New concerns and ideas
 Resident Concerns
 Facility News-information to share from department heads
 Social Time-Wind down/ refreshments
Minutes
WHAT: Accurate record made of all happenings at each meeting, who served,
facility’s actions in response to concerns of the council.
WHY: Communication tool/sharing outcomes and useful written record.
WHO: Secretary takes minutes or designate someone.
Brief, Legible, and for anyone to understand, typed and copies made for
distribution (given to all residents or posted).
 The name of the person presiding
 Members present
 Who took minutes
 Date and time of the meeting
 All items discussed, actions taken
 Date and time of next meeting
Formality of Structure
Ensure that the council knows where it is
heading and that there is a democratic and fair
way for the council to do its work and make
decisions. http://theconsumervoice.org/uploads/files/family-member/Developing-andSuporting-Family-Councils.pdf
By-laws
Policies
By-Laws
Written guidelines by which the group
operates.
 Name
 Purpose/ Mission Statement
 Membership (criteria)
 Officers and committees (tiles, responsibilities,
terms)
 Meetings (when and how is conducted)
 Elections (nomination, procedures)
 Rules of Order (raise hand, talking stick)
 Future Amendments
Policies
Communication with administrator/staff
Communication of concerns to
administrator/ staff
Communication with other family
members
Communication with residents
Handling individual concerns
Problem Solving
Will this help improve resident care and residents’ lives?
 Narrow down and pinpoint the specific problems
 Learning current policy on a facility issue
 Learning what laws and regulations require
The role of the council is not just to identify problems, but
to offer ideas and suggestions about how to resolve them.
http://www.ltcombudsman.org/sites/default/files/norc/issues/Omb-and-Family-CouncilsLAFMC.pdf
Promoting
Many family councils have active participation of 10%
of families of the residents.
http:/theconsumervoice.org/uploads/files/issues/promoting-participation-2012.pdf
 Flyer
 Newsletter
 Membership Form
 Permission to Contact
 Greeter in lobby
 Mailings
 Staff
What to say?…………….
Image 8 megaphone.png
Ombudsman Role
Yes! Encouragement!
(Yoga instructor from Couples
Retreat Movie)
Coach
Educator/ Trainer
Connector
Mediator
Communication/ Meeting
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Respect
Trust, Care, and Concern
Good Listener
Observation
Give/ Receive/ Share Information
Confidentiality
Recognition
Patience
Sense of Humor
Criticism
Mistakes
Laugh at Self
People’s Well-Being
Admit not knowing
Alternatives
Praise
(Retrieved from Resident/Family Council folder in
Ombudsman Office)
Communication/ Processing Concerns
 Officers having regular monthly meeting with administrator/ keep
members informed (make an appointment in advance).
 Allow reasonable time for complaint to be resolved.
 Hear constructive input/ get all facts.
 Address small concerns before they become major problems.
 Work toward meaningful change, avoid unreasonable demands.
 Present ideas in a non-threatening way (friendly, but firm).
 Avoid generalities and exaggerations.
 Show appreciation.
 Facility clear on the purposes and rights of your council / value of
cooperation.
(Retrieved from Resident/Family Council folder in Ombudsman Office)
Obstacles
FEAR OF RETALIATION
LACK OF INTEREST
LACK OF TIME
LACK OF INFORMATION
LACK OF SUPPORT FROM THE FACILITY
DISCOURAGED EASILY
LOW PARTICIPATION
NOT WANT LEADERSHIP ROLE
Benefits
 In-service training
 Improve staffing assignments and stopped staff rotation
 Survey, improvements to facility
 Better service to residents (food, daily care, bathing
time, activities, etc...)
 Grievance Forms at nurses station
 Staff appreciation and educational programs
 Billing/ Delivery issue with pharmacy
 Council put in admission packet
 Open lines of communication
Resources
How to Organize and Direct an Effective Resident Council: A Technical Assistance Manual of the
Missouri Long-Term Care Ombudsman Program. Emmelene W. Kerr. Missouri Long-Term Care
Ombudsman Program. This manual covers all aspects of council work – from forming a new council to
improving an existing council Written by a former coordinator in the Missouri Ombudsman Program who draws
upon many years of ombudsman experience with resident councils, ombudsmen will find straight forward
information and tips to use when assisting in the formation or strengthening of a resident council.
http://health.mo.gov/seniors/ombudsman/publications.php
Family Guide to Effective Family Councils
Prepared by Robyn Grant for The Legal Assistance Foundation of
Metropolitan Chicago and the Evanston Commission on Aging
Additional copies: Kathy Swanson c/o Legal Assistance Foundation of Metropolitan Chicago
111 W. Jackson Boulevard 3rd floor
Chicago, IL 60604
http://theconsumervoice.org/uploads/files/family-member/Guide-toEffective-Family-Councils.pdf
Long Term Care Ombudsman Guide to Developing and Supporting Family Councils
Prepared by Robyn Grant for The Legal Assistance Foundation of Metropolitan Chicago
111 W. Jackson Boulevard 3rd floor
Chicago, IL 60604
http://theconsumervoice.org/uploads/files/family-member/Developing-and-Suporting-Family-Councils.pdf
Parliamentary Charts and Handouts
http://www.jimslaughter.com/uploads/OrderofBusiness.pdf
Image References
Image 1: Retrieved from http://ts1.mm.bing.net/th?&id=HN.608049579972823833&w=315&h=300&c=0&
Image 2: Retrieved from
http://www.etftrends.com/wp-content/uploads/2010/07/avoidance300.jpg
Image3: Retrieved from
http://www.northsidenaz.org/images/clipart_people_desk_meeting_19909_1920x1200.jpg
Image 4: Retrieved from
http://ts1.mm.bing.net/th?&id=HN.608038842553010247&w=300&h=300&c=0
Image 5: Retrieved from
http://www.unioncountynj.org/news/2008/0803runemployee.jpg
Image 6 Retrieved from
http://radbusinessassociation.files.wordpress.com/2012/03/graphics-agenda-603334.jpg
Image 7: Retrieved from
http://1.bp.blogspot.com/-Wl3ehSD-Iv0/UF3c5qGxtfI/AAAAAAAAARI/OhhmeHNCUmU/
Image 8 Retrieved from
http://www.mistera.co.uk/uploaded/megaphone.png
Image 9: Retrieved from
http://www.crossfitboilerroom.com/wp-content/uploads/2013/11/carlos-ponce-yoga-